- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.06 / $47.68 / $73.92
| Professional | | $32.06 | $47.68 | $73.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.48 / $47.87 / $75.63
| Professional | | $45.48 | $47.87 | $75.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.01 / $98.81 / $234.14
| Professional | | $43.01 | $98.81 | $234.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.13 / $50.47 / $135.99
| Professional | | $34.13 | $50.47 | $135.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.16 / $92.66 / $143.55
| Professional | | $49.16 | $92.66 | $143.55 |